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Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
of health care – have been achieved. The four main e-health projects were reviewed in the audit: Electronic Health Record, Digital Prescription, Digital Registration and Digital Image. The problems ... Estonia’s population is aging and the share of elderly people is increasing, as fewer children are being born and people are living longer. This creates a constantly growing need for health ... and social services and patients are also becoming more and more demanding about the volume and quality of the services provided. The more extensive and systematic implementation of e-health solutions helps ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... The report reviews whether the objectives set to the e-Health – ambitious multiyear program of Estonian Government - have been achieved. They are: higher quality of the health service and more ... efficient organisation of health care. As SAI Estonia found out, wide range problems started from two basic points: lack of strategic manager and unrealisitc schedule.
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of health care – have been achieved. The four main e-health projects were reviewed in the audit: Electronic Health Record, Digital Prescription, Digital Registration and Digital Image. The problems ... Estonia’s population is aging and the share of elderly people is increasing, as fewer children are being born and people are living longer. This creates a constantly growing need for health ... and social services and patients are also becoming more and more demanding about the volume and quality of the services provided. The more extensive and systematic implementation of e-health solutions helps ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... The report reviews whether the objectives set to the e-Health – ambitious multiyear program of Estonian Government - have been achieved. They are: higher quality of the health service and more ... efficient organisation of health care. As SAI Estonia found out, wide range problems started from two basic points: lack of strategic manager and unrealisitc schedule.
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National Audit Office of Estonia
, issued in 2014
Risk cases: 3
Identifying and meeting central government's skills requirements
Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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National Audit Office
, issued in 2011
Risk cases: 6
Does the state administration effectively use the stored information?
State administration could use the accumulated information more effectively Latvian auditors found that government institutions have a good cooperation in the area of data use, but there are still several areas wherein a person still has to perform the function of a 'courier'. Many channels of data exchange and distribution used in state administration create a fragmented and complicated environment for maintenance of ICT, while responsible ministry does not become actively involved and does not coordinate cooperation of institutions.
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State administration could use the accumulated information more effectively Latvian auditors found that government institutions have a good cooperation in the area of data use, but there are still several areas wherein a person still has to perform the function of a 'courier'. Many channels of data exchange and distribution used in state administration create a fragmented and complicated environment for maintenance of ICT, while responsible ministry does not become actively involved and does not coordinate cooperation of institutions.
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State Audit Office of the Republic of Latvia
, issued in 2017
Risk cases: 4
Improved Planning and Performance Measures Are Needed to Help Ensure Successful Technology Modernization
Massive modernization effort needs coordination Social security issues can touch lives of many. Information technology in this area are increasingly costly and difficult to maintain. GAO is recommending to develop comprehensive metrics to effectively gauge modernization progress; complete comprehensive strategic planning, including its enterprise architecture; and define the new roles and responsibilities to help ensure effective oversight.
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Massive modernization effort needs coordination Social security issues can touch lives of many. Information technology in this area are increasingly costly and difficult to maintain. GAO is recommending to develop comprehensive metrics to effectively gauge modernization progress; complete comprehensive strategic planning, including its enterprise architecture; and define the new roles and responsibilities to help ensure effective oversight.
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General Accountability Office
, issued in 2012
Risk cases: 3
FEMA Needs to Address Management Weaknesses to Improve Its Systems
Controls in emergency management GAO audited the agency of the Department of Homeland Security, responsible for federal efforts to mitigate, respond to, and recover from disasters. American auditors recommend that the agency fully define its investment board’s roles and responsibilities and procedures for selecting and overseeing investments, update its strategic plan and complete plans for IT modernization, and establish time frames for completing workforce planning efforts. The agency should also establish policies and guidance for implementing key IT management controls.
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Controls in emergency management GAO audited the agency of the Department of Homeland Security, responsible for federal efforts to mitigate, respond to, and recover from disasters. American auditors recommend that the agency fully define its investment board’s roles and responsibilities and procedures for selecting and overseeing investments, update its strategic plan and complete plans for IT modernization, and establish time frames for completing workforce planning efforts. The agency should also establish policies and guidance for implementing key IT management controls.
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General Accountability Office
, issued in 2016
Risk cases: 4
Electronic Records. Management and Preservation Pose Challenges
Basics of electronic records management This audit of GAO, reported in 2003, can be helpful in looking for basic problems in electronic records management. These problems are compounded as computer hardware, application software, and even storage media become obsolete, as they may leave behind electronic records that can no longer be read.
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Basics of electronic records management This audit of GAO, reported in 2003, can be helpful in looking for basic problems in electronic records management. These problems are compounded as computer hardware, application software, and even storage media become obsolete, as they may leave behind electronic records that can no longer be read.
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General Accountability Office
, issued in 2003
Risk cases: 7
OMB and Agencies Need to Focus Continued Attention on Implementing Reform Law
How to invest efficiently in IT IT investments are large and growing position in annual budgets. Historically, they have frequently failed, incurred cost overruns and schedule slippages, or contributed little to mission-related outcomes. GAO recommendations focus on the oversight and execution of the data center consolidation initiative, the accuracy and reliability of the IT Dashboard, and incremental development policies.
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How to invest efficiently in IT IT investments are large and growing position in annual budgets. Historically, they have frequently failed, incurred cost overruns and schedule slippages, or contributed little to mission-related outcomes. GAO recommendations focus on the oversight and execution of the data center consolidation initiative, the accuracy and reliability of the IT Dashboard, and incremental development policies.
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General Accountability Office
, issued in 2016
Risk cases: 3
Report on the problems connected with the development and implementation of the digitally based Shared Medication Record
The purpose of the examination was to assess whether the department of the Danish Ministry of Health, the Danish National eHealth Authority (NHA) and the five regions that are responsible ... for the hospitals have made an adequate effort to develop and implement the Shared Medication Record (SMR). With the SMR, data on the citizens’ medication can be shared across hospitals, general practitioners, etc ... . and relevant health staff and the patients have direct digital access to updated medical data round the clock. The report answers the following questions: 1) Has the Ministry of Health and the NHA provided ... ... Involvement of key participants necessary from the very beginning ... Digitally based Shared Medication Record is basis of the complex healthcare system. Rigsrevisionen analysed unsolved issues related to unclear business case, insufficient analysis of work flows ... and processes leading to implementation problems, governance not involving key players, and IT security organisation.
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The purpose of the examination was to assess whether the department of the Danish Ministry of Health, the Danish National eHealth Authority (NHA) and the five regions that are responsible ... for the hospitals have made an adequate effort to develop and implement the Shared Medication Record (SMR). With the SMR, data on the citizens’ medication can be shared across hospitals, general practitioners, etc ... . and relevant health staff and the patients have direct digital access to updated medical data round the clock. The report answers the following questions: 1) Has the Ministry of Health and the NHA provided ... ... Involvement of key participants necessary from the very beginning ... Digitally based Shared Medication Record is basis of the complex healthcare system. Rigsrevisionen analysed unsolved issues related to unclear business case, insufficient analysis of work flows ... and processes leading to implementation problems, governance not involving key players, and IT security organisation.
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National Audit Office of Denmark
, issued in 2014
Risk cases: 2
Use of consultants and temporary staff
New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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National Audit Office
, issued in 2016
Risk cases: 7
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2